Core beliefs can be divided into three categories:

Helplessness
Unlovability
Worthlessness

Helpless core beliefs
I am incompetent I am ineffective. I cant do anything right. I am helpless. I
am powerless. I am weak. I am vulnerable. I am a victim.
Unlovable core beliefs
I am unlovable. I am unlikeable. I am undesirable. I am unattractive. I am
unwanted. I am uncared for.
Worthless core beliefs
I am worthless. I am unacceptable. I am bad. I am a waste.
I am needy. I am trapped. I am out of control. I am a failure. I am
defective [i.e., I do not measure up to others]. I am not good enough [in terms of
achievement]. I am a loser.
I am different. I am bad [so others will not love me]. I am defective [so others
will not love me]. I am not good enough [to be loved by others]. I am bound to
be rejected. I am bound to be abandoned. I am bound to be alone.
I am immoral. I am dangerous. I am toxic. I am evil. I dont deserve to
live.
But where do automatic thoughts spring from? What makes one person construe a
situation differently from another person? Why may the same person interpret an
identical event differently at one time than at another? The answer has to do with
more enduring cognitive phenomena: beliefs.
CORE BELIEFS:
- Fundamental enduring understandings
- Absolute truths Just the way things are
- When a core belief is activated most of the time, one may interpret a situation
through the lens of this belief. Even though the interpretation is invalid on a
rational basis.
- Occurs automatically
- Global, rigid and overgeneralized.
- Core beliefs about: the SELF (I am incompetent), OTHERS (Other people are
untrustworthy) and the WORLD (The world is dangerous).

The quickest way to help patients feel better and behave more adaptively is to facilitate
the direct modification of their core beliefs as soon as possible, so that they can
interpret future situations or problems in a more constructive way.
The usual course of treatment in cognitive behavior therapy:
1. Initial emphasis on identifying and modifying automatic thoughts that derive
from the core beliefs (and on interventions that indirectly modify core beliefs).
2. Identify these cognitions that are closest to conscious awareness, and to gain
distance from them by learning. Changing their thinking so it is more reality
based and useful helps them feel better and progress toward their goals.


Within this schema is Reader Es core belief: Im incompetent. When Reader E is presented with
negative data this schema becomes activated, and the data, contained in negative rectangles, are
immediately processed as confirming his core belief, which makes the belief stronger.
But a different process occurs when Reader E is presented with posi- tive data (such as analyzing which
health care plan would be best for his family). Positive data are encoded in the equivalent of positive
triangles, which cannot fit into the schema. His mind automatically discounts the data (I chose a health
care plan, but it took me a long time.) When his boss praised him, he immediately thought, My boss is
wrong. I didnt do that project well. I didnt deserve it *his praise+. These interpreta- tions, in essence,
change the shape of the data from positive triangles to negative rectangles. Now the data fit into the
schema and, as a result, strengthen the negative core belief.
There are also positive data that Reader E just does not notice. He does not negate some evidence of
competence, such as paying his bills on time or fixing a plumbing problem. Rather, he does not seem to
process these positive data at all; they bounce off the schema. Over time, Reader Es core belief of
incompetence becomes stronger and stronger.

HIERARCHY OF COGNITION:
Core beliefs

Intermediate beliefs (rules, attitudes, assumptions)

Situation

Automatic thoughts

Reaction (emotional, behavioral, physiological)
INTERMEDIATE BELIEFS:
- Consists of attitudes, rules and assumptions
- From example above:
Attitude: Its terrible to fail.
Rule: Give up if a challenge seems too great.
Assumptions: If I try to do something difficult, Ill fail. If I avoid doing it, Ill be okay.


Triggering situations can be:
Discrete events (such as getting a low mark on a paper).
A stream of thoughts (such as thinking about doing schoolwork or intrusive
thoughts).
A memory (such as getting a poor grade in the past).
An image (such as the disapproving face of a professor).
An emotion (such as noticing how intense ones dysphoria is).
A behavior (such as staying in bed).
A physiological or mental experience (such as noticing ones rapid heartbeat or
slowed-down thinking).

Cognitive Conceptualization for example above:


IDENTIFYING AND MODIFYING CORE BELIEFS:
How?
1. Mentally hypothesize from which category of core belief specific automatic
thoughts appear to have arisen? (Helplessness / unlovability / worthlessness)
2. Specify the core belief to yourself
3. Present your hypothesis to client. Ask for confirmation / disconfirmation. Refine
your hypothesis.
4. Educate client about core beliefs in general and about their specific core beliefs
(negative & positive).
5. Help client specify and strengthen a new and more adaptive core belief.
6. Evaluate and modify the negative core belief with client. Take note of the
following:
a. Childhood origin if applicable
i. Hypothesize to clients how they came to believe a core belief
ii. Explain how the core belief could be untrue or mostly untrue even
though they currently believe it so strongly.
b. Maintenance through the years
c. Contribution to clients present difficulties
*Decrease the strength and influence of the old core belief through
intellectual/emotional/ experiential methods and increase the strength of the new
one.
I. Identifying Core Beliefs:
Downward arrow technique
THERAPIST: What went through your mind when you couldnt finish the statistics assignment?
PATIENT: I cant do anything right. Ill never be able to make it here.
THERAPIST: *downward arrow technique+ And if thats true, that you cant do anything right and you cant
make it here, what does that mean?
PATIENT: *core belief+ Im hopeless. Im so incompetent.
II. Presenting Core Beliefs:
Go signal to present clients core belief/s -> When you have collected sufficient data to
hypothesize about clients core belief and when you think patient is receptive of this
hypothesis.
You may: Review their ATs and ask them to draw a conclusion as to an underlying
pattern OR you may also explore childhood precursors (A. Hypothesize to clients how
they came to believe a core belief; B. Explain how the core belief could be untrue or
mostly untrue even though they currently believe it so strongly.)
III. Educating Clients about their Core Beliefs and Monitoring their operation:
Counselor must first make sure that client confirms his/her conceptualization.
Client must understand the following about Core Beliefs:

THERAPIST: Sally, does this [automatic thought that she will not be able to write her economics paper]
sound familiar? Do you think your idea that youre incompetent could be getting in the way?
PATIENT: Yeah. I do feel incompetent.
THERAPIST: Well, Sally, one of two things has been going on. The problem is either you really are
incompetent, and well have to do some work together to make you more competent ... or the problem is
that you believe you are incompetent; and sometimes, you believe it so strongly that you actually act in
an incompetent way, like not going to the library to start researching your paper. (pause) What do you
think?
PATIENT: I dont know.
THERAPIST: Why dont we write these two possibilities on paper? This is what Id like to start doing in
therapy, if it is okay with you, seeing which possibility seems more truethat you really are incompe-
tent, or that you believe youre incompetent.
Counselor later on explains to client what CB generally is (in small parts) and why client
believes in his/her CBs strongly. Counselor must make sure client understands as they
proceed with therapy.

IV. Developing a New Core Belief:
A relatively positive belief is generally easier to adopt than a belief that is at an extreme.
Some clients may easily identify this belief, while others cannot. As a counselor, you
must mentally devise a new, more realistic and functional belief and guide clients
toward it.
Weaken the first (negative) belief -> Strengthen the second (positive) belief

V. Strengthening New Core Beliefs:
1. From beginning of treatment: wherein the counselor deliberately elicits positive
data from client through questioning and point out to client this positive data
(which may contradict the old and negative core belief thus supporting a new
and more reality-based belief).
2. Counselor asks client to examine their experiences in a way that facilitates their
ability to recognize positive data on their own.
a. Credit List
b. Core Belief Worksheet
- This will help client adopt a different view of their experiences.
* Important: Track with client how strongly they believe their own core belief over time
(both at an intellectual and emotional level).

Belief Modification may not be successful if clients:
Have core beliefs that are quite rigid and overgeneralized.
Do not yet believe that cognitions are ideas and not necessarily truths.
Experience very high levels of affect when beliefs are elicited or questioned.
Do not have a strong enough alliance with you (they may not trust you
sufficiently; they may not perceive you as understanding who they really are;
they may feel invalidated by the process of belief evaluation).